Woman in her late 20’s with the ovaries of someone in her 40’s: Premature Ovarian Failure
Our patient was in her late 20’s, but she had the ovaries of a woman in her 40’s
I want to share an incredible story about a 28 year old patient of mine who had never been pregnant after trying for over a year. She did not know it, but her ovaries had prematurely aged. Her evaluation showed very poor ovarian reserve, with an FSH 12, an AMH 0.3, and a poor ovarian antral follicle count. Functionally, she had the ovaries of a woman in her 40’s. This is not that uncommon as about 1% of women experience menopause prior to the age of 37, which is called premature ovarian failure (POF). With this in mind, I recommended that she take an aggressive treatment strategy.
About 1% of women experience menopause prior to the age of 37, which is called premature ovarian failure (POF).
The patient able to conceive using stimulated IVF and PGS
My patient decided to do stimulated IVF and despite using high doses of fertility drugs, she only produced 2 eggs. Both were fertilized and developed to blastocysts, so both were biopsied and tested using PGS (preimplantation genetic screening). One of the two embryos was genetically normal. I performed a simple embryo transfer, and she is now pregnant and a strong fetal heartbeat was present on her sonogram. She has been referred back to her Obstetrician.
If you have any patients who have been trying to conceive for a year or more and have not been able to get pregnant, we recommend a simple infertility evaluation.
The evaluation takes only 3 or 4 weeks to complete, and often contains valuable information for you and for your patient.
It is also important to note that infertility that is caught and treated early is associated with much better outcomes, much like other medical conditions. Had my patient or her referring doctor waited another year or two, she might have developed POF. Then her only options would have been donor egg IVF or adoption.
Because her condition was caught early, we expect a happy outcome for this patient in about 8 months, and we are thrilled by her success.
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